Navigating the autism assessment process and mainstream education as an autistic adolescent girl

Abstract

Section A
This systematic review explores the lived experiences of autistic girls in UK mainstream education, synthesising findings from 11 qualitative studies published between 2015 and 2025. Data from the included studies were analysed using thematic synthesis guided by Thomas and Harden's (2008) framework. The analysis reveals four central themes that collectively highlight a system failing to deliver genuine inclusion. First, masking is employed as a constant, exhausting survival strategy to fit in. This results in significant psychological costs, including high rates of anxiety and self-harm, and causing girls’ needs to be systematically overlooked by staff. Second, the mainstream school environment is hostile, characterised by overwhelming sensory demands and the chaotic burden of unstructured social time. Third, despite a strong motivation for connection, participants face pervasive social exclusion and struggle to navigate the complex "hidden curriculum”. Crucially, these challenges are exacerbated by a systematic misunderstanding and lack of staff training regarding the female autistic phenotype, often leading to distress being misinterpreted as defiance. The review concludes that achieving inclusion demands urgent, individualised, and neuro-affirming relational and environmental reforms to validate and support all autistic girls.

Section B
Autism diagnostic criteria and tools remain grounded in male-typical presentations, limiting sensitivity to the internalised profiles and camouflaging strategies often observed in girls. This contributes to identification delays, leaving the needs of adolescent girls overlooked within UK diagnostic pathways. There is a critical need to capture the voices of girls navigating the assessment process during this formative developmental window. This present study used Interpretative Phenomenological Analysis (IPA) to explore the lived diagnostic assessment experiences of nine autistic adolescent girls (aged 13-18) in the UK. Three themes emerged: "The Invisible Girls", exploring how masking leads to systemic invisibility; "Navigating Power in the Assessment Process", examining the impact of clinical dynamics on adolescent participants; and "The Utility of the Label", highlighting the role of diagnosis in providing validation and accessing support. The findings suggest that clinical practice must move toward relationally flexible, expert-to-expert dialogues that prioritise the adolescent’s self-knowledge over rigid, standardised behavioral observation.

Date of Award	2026
Original language	English
Awarding Institution	Canterbury Christ Church University